Skip to main content

Advertisement

Log in

Comparison of Posterolateral Thoracotomy and Video-Assisted Thoracoscopic Clipping for the Treatment of Patent Ductus Arteriosus in Neonates and Infants

  • Original Article
  • Published:
Pediatric Cardiology Aims and scope Submit manuscript

Abstract

This study was designed to compare the long-term clinical outcomes and costs between video-assisted thoracic surgery (VATS) and posterolateral thoracotomy (PT) in neonates and infants. This study enrolled 302 patients with isolated patent ductus arteriosus (PDA) from January 2002 to 2007 and followed them up until April 2010. A total of 134 patients underwent total VATS (VATS group), and 168 underwent PDA closure through PT (PT group). The two groups were compared according to clinical outcomes and costs. The demographics and preoperative clinical characteristics of the patients were similar in the two groups. No cardiac deaths occurred, and the closure rate was 100% successful in both groups. The operating, recovery, and pleural fluid drainage times were significantly shorter in the VATS group than in the PT group. Statistically significant differences in length of incision, postoperative temperature, and acute procedure-related complications were observed between the two groups. The cost was $1,150.3 ± $221.2 for the VATS group and $2415.8 ± $345.2 for the PT group (P < 0.05). No cardiac deaths or newly occurring arrhythmias were detected in either group during the follow-up period. Statistically significant differences in the rate of residual shunt and scoliosis were observed between the two groups. The left ventricular end-diastolic diameter and the pulmonary artery diameter could be restored to normal in the VATS group but not in the PT group. The study confirmed that VATS offers a minimally traumatic, safe, and effective technique for PDA interruption in neonates and infants.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

References

  1. Albanese CT, Sydorak RM, Tsao K, Lee H (2003) Thoracoscopic lobectomy for prenatally diagnosed lung lesions. J Pediatr Surg 38:553–555

    Article  PubMed  Google Scholar 

  2. Bensky AS, Raines KH, Hines MH (2000) Late follow-up after thoracoscopic ductal ligation. Am J Cardiol 86:360–361

    Article  PubMed  CAS  Google Scholar 

  3. Burke RP, Jacobs JP, Cheng W, Trento A, Fontana GP (1999) Video-assisted thoracoscopic surgery for patent ductus arteriosus in low-birth-weight neonates and infants. Pediatrics 104:227–230

    Article  PubMed  CAS  Google Scholar 

  4. Chen Z, Chen L, Wu L (2009) Transcatheter amplatzer occlusion and surgical closure of patent ductus arteriosus: comparison of effectiveness and costs in a low-income country. Pediatr Cardiol 30:781–785

    Article  PubMed  Google Scholar 

  5. Cherif A, Khrouf N, Jabnoun S, Mokrani C, Amara MB, Guellouze N, Kacem S (2008) Randomized pilot study comparing oral ibuprofen with intravenous ibuprofen in very-low-birth-weight infants with patent ductus arteriosus. Pediatrics 122:e1256–e1261

    Article  PubMed  Google Scholar 

  6. Cho J, Yoon YH, Kim JT, Kim KH, Lim HK, Jun YH, Hong YJ, Baek WK (2010) Patent ductus arteriosus closure in prematurities weighing less than 1 kg by subaxillary minithoracotomy. J Korean Med Sci 25:24–27

    Article  PubMed  Google Scholar 

  7. Demir T, Oztunç F, Cetin G, Saltik L, Eroglu AG, Babaoglu K, Ahunbay G (2007) Patency or recanalization of the arterial duct after surgical double ligation and transfixion. Cardiol Young 17:48–50

    Article  PubMed  Google Scholar 

  8. Eerola A, Jokinen E, Boldt T, Pihkala J (2006) The influence of percutaneous closure of patent ductus arteriosus on left ventricular size and function: a prospective study using two- and three-dimensional echocardiography and measurements of serum natriuretic peptides. J Am Coll Cardiol 47:1060–1066

    Article  PubMed  Google Scholar 

  9. Fan LL, Campbell DN, Clarke DR, Washington RL, Fix EJ, White CW (1989) Paralyzed left vocal cord associated with ligation of patent ductus arteriosus. J Thorac Cardiovasc Surg 98:611–613

    PubMed  CAS  Google Scholar 

  10. Gross R, Hubbard J (1939) Surgical ligation of a patent ductus arteriosus: report of a first successful case. JAMA 112:729–731

    Google Scholar 

  11. Hines MH, Raines KH, Payne RM, Covitz W, Cnota JF, Smith TE, O’Brien JJ, Ririe DG (2003) Video-assisted ductal ligation in premature infants. Ann Thorac Surg 76:1417–1420

    Article  PubMed  Google Scholar 

  12. Jeong YH, Yun TJ, Song JM, Park JJ, Seo DM, Koh JK, Lee SW, Kim MJ, Kang DH, Song JK (2007) Left ventricular remodeling and change of systolic function after closure of patent ductus arteriosus in adults: device and surgical closure. Am Heart J 154:436–440

    Article  PubMed  Google Scholar 

  13. Kennedy AP, Synder CL, Ashcraft KW, Manning PB (1998) Comparison of muscle-sparing thoracotomy and thoracoscopic ligation for the ligation for the treatment of patent ductus arteriosus. J Pediatr Surg 33:259–261

    Article  PubMed  Google Scholar 

  14. Koontz CS, Oliva V, Gow KW, Wulkan ML (2005) Video-assisted thoracoscopic surgical excision of cystic lung disease in children. J Pediatr Surg 40:835–837

    Article  PubMed  Google Scholar 

  15. Lukish JR (2009) Video-assisted thoracoscopic ligation of a patent ductus arteriosus in a very-low-birth-weight infant using a novel retractor. J Pediatr Surg 44:1047–1050

    Article  PubMed  Google Scholar 

  16. Mavroudis C, Backer CL, Gevitz M (1994) Forty-six years of patent ductus arteriosus division at Children’s Memorial Hospital of Chicago: standards for comparison. Ann Surg 220:402–410

    Article  PubMed  CAS  Google Scholar 

  17. Nezafati MH, Mahmoodi E, Hashemian SH, Hamedanchi A (2002) Video-assisted thoracoscopic surgical (VATS) closure of patent ductus arteriosus: report of three-hundred cases. Heart Surg Forum 5:57–59

    PubMed  CAS  Google Scholar 

  18. Sorenson KE, Kristensen B, Hansen OK (1991) Frequency of occurrence of residual ductal flow after surgical ligation by color-flow mapping. Am J Cardiol 67:653–654

    Article  Google Scholar 

  19. Villa E, Vanden Eynden F, Le Bret E, Folliguet T, Laborde F (2004) Paediatric video-assisted thoracoscopic clipping of patent ductus arteriosus: experience in more than 700 cases. Eur J Cardiothorac Surg 25:387–393

    Article  PubMed  Google Scholar 

  20. Weng GX, Xie Q, Wang H (2000) The interruption of patent ductus arteriosus with video-assisted thoracic operation: a comparison with the conventional transthoracic approach. Chin J Clin Thorac Cardiovasc Surg 7:160–161

    Google Scholar 

  21. Westfelt JN, Nordwall A (1991) Thoracotomy and scoliosis. Spine 16:1124–1125

    Article  PubMed  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Guoxing Weng.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Chen, H., Weng, G., Chen, Z. et al. Comparison of Posterolateral Thoracotomy and Video-Assisted Thoracoscopic Clipping for the Treatment of Patent Ductus Arteriosus in Neonates and Infants. Pediatr Cardiol 32, 386–390 (2011). https://doi.org/10.1007/s00246-010-9863-x

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00246-010-9863-x

Keywords

Navigation